MICHAEL BOURGEOIS


Address: 4102 24th St Ste 507, Lubbock, TX 79410-1805
Phone: 8067437334

MICHAEL BOURGEOIS (NPI# 1457342842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457342842
Entity Type Individual
Full Name MICHAEL BOURGEOIS
Credential M.D.
Practice Address 4102 24th St Ste 507
Lubbock
TX 79410-1805
Mailing Address Po Box 5865
Lubbock
TX 79408-5865
Practice Telephone 8067437334
Practice Fax Number 8067437332
Mailing Telephone 8067432898
Mailing Fax Number 8067432787
Enumeration Date 2005-11-03
Last Update Date 2018-10-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0205X Pediatrics
Specialization: Pediatric Endocrinology
F5842 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX FIRSTCARE COMMERCIAL 108958105 01
TX 138369711 05
NM V2944 05
OK 100086010B 05
TX HMO BLUE 80822Z 01
TX 138369704 05
NM 36233 05
TX BC/BS 89C152 01
TX RAILROAD 460001727 01
NM PRESBYTERIAN COMMERCIAL 36233 01
NM TRIWEST A119 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
3601 4th St, Lubbock, TX 794300002 8067437337 8067437329

Other Providers MICHAEL BOURGEOIS

NPI Name Taxonomy Address Enumeration
1740202555 Michael O'donnell Bourgeois Internal Medicine Lsu Healthcare Network, 3401 North Blvd, Suite 400, Baton Rouge, LA 70806 2006-07-24
1871585901 Michael Charles Bourgeois Pharmacist 31003 Sherrie Ln, Magnolia, TX 77354-5793 2005-08-16
1730641648 Michael Jean Bourgeois Student in an Organized Health Care Education/Training Program 1638 Owen Dr, Fayetteville, NC 28304-3424 2019-04-01

Office Location

Street Address 4102 24TH ST STE 507
City LUBBOCK
State TX
Zip Code 79410-1805

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851387393 Surendra Varma Pediatrics 4102 24th St Ste 507, Lubbock, TX 79410-1805 2005-09-20
1851935365 Jasmine Sanchez-ximenez Nurse Practitioner 4102 24th St Ste 507, Lubbock, TX 79410-1805 2019-10-29
1932611969 Texas Tech University Health Sciences Center Lubbock Durable Medical Equipment & Medical Supplies 4102 24th St Ste 507, Lubbock, TX 79410-1805 2017-10-31
1124205513 Nancy Louise Beck Pediatrics 4102 24th St Ste 507, Lubbock, TX 79410 2008-01-28
1518905934 Adaobi Kanu Pediatrics 4102 24th St Ste 507, Lubbock, TX 79410 2006-06-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548878267 Covenant Medical Center Clinic/Center 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 2020-07-20
1669038626 Hub City Anesthesia Nurse Anesthetist, Certified Registered 3416 22nd Street, Lubbock, TX 79410 2019-05-15
1912447418 Lubbock Surgery Center, LLC Clinic/Center 3416 22nd St, Lubbock, TX 79410 2017-03-02
1871032698 Lezlee Berry Pharmacist 3615 19th Street, Lubbock, TX 79410 2017-02-13
1376914101 Matthew Cotton Nurse Practitioner 2424 Quaker Ave, Lubbock, TX 79410 2015-10-20
1841534864 Frank Nwabugwu Pharmacist 4120 34th Street, Lubbock, TX 79410 2012-11-15
1689954794 Dharmendra Kumar Pediatrics Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 2011-08-19
1518277177 T.r.m. Rao, M.d., P.a. Colon & Rectal Surgery 3809 22nd Street, Suite C, Lubbock, TX 79410 2010-10-18
1700196672 Hanford Consultations P.a. Family Medicine 4000 22nd Place Suite 100, Lubbock, TX 79410 2010-10-13
1336452598 Amanda Collins Specialist 4801 34th Street, Lubbock, TX 79410 2010-07-16
Find all providers in zip 79410

Taxonomy Information

Taxonomy Code 2080P0205X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Endocrinology

Taxonomy Definition

A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851387393 Surendra Varma Pediatrics 4102 24th St Ste 507, Lubbock, TX 79410-1805 2005-09-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1073912325 Pediatric Endocrinology Clinic Pediatrics 4302 S Sugar Rd Ste 205, Edinburg, TX 78539-9140 2014-08-21
1215292875 Amrita Anil Waingankar Pediatrics 7711 O Connor Dr Apt 2502, Round Rock, TX 78681 2012-07-10
1447554860 Pediatric Endocrinology of Central Texas Pllc Pediatrics 1605a Redwood Road, San Marcos, TX 78666-1424 2010-12-28
1164757712 Virginia Cortes Araiza Pediatrics 3701 W Alabama St Ste 350, Houston, TX 77027-5264 2009-10-14
1992952758 Jose David Gamez Pediatrics 2821 Michaelangelo Dr Ste 102a, Edinburg, TX 78539-1411 2008-08-24
1639356108 Farah Mehdi Khatoon Pediatrics 8611 N Mopac Expy, Austin, TX 78759-8319 2008-01-28
1730378456 Vandana S Raman Pediatrics 6621 Fannin St # Cc102005, Suite 1020, Houston, TX 77030-2303 2007-10-18
1154544054 Amy M. Burton Pediatrics 6124 W Parker Rd Ste 230, Plano, TX 75093-8124 2007-04-10
1295870459 Southwestern Diabetic Physicians Association Pediatrics 10687 Fm 678, Whitesboro, TX 76273-4840 2007-02-21
1881776367 Otto Velasquez Md Phd & Associates Pediatrics 5111 N 10th St # 281, Mcallen, TX 78504-2835 2006-10-20
Find all providers with the same taxonomy

Competitor

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City LUBBOCK
Zip Code 79410

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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